We’ve all heard about the current opioid epidemic and the increase in the number of deaths due to opioid overdose. Let’s quickly review:
- The number of overdose deaths in the U.S. involving opioids has more than quadrupled between 1999 and 2015, with more than 33,000 deaths in 2015
- Acute and chronic pain affects approximately 100 million adultsin the U.S. and an increasing number take prescription opioid medication to treat their pain
- Most drug overdose deaths involve an opioid medication.
What is the impact of this epidemic on service members? We know prescription opioid medication abuse in service members negatively impacts performance, military readiness and the overall mission. But the data is encouraging.
One study found that chronic pain and prescription opioid use rates in the military were approximately 44 percent higher than in the general population, possibly related to deployment effects such as injuries, combat exposure and mental health conditions. Yet prescription drug abuse in the military is low and on the decline. According to the Military Health System Data Repository, there was a 34 percent decrease in the number of service members receiving a diagnosis of opioid drug dependence or opioid abuse from 2012 to 2016 and opiate positive drug tests among service members declined more than 60 percent between fiscal years 2013 and 2016.
As clinicians we know that continuous education (our own as well as for service members) is important to remind them of the zero tolerance policies for prescription drug abuse, to increase awareness of the health and safety risks of drug misuse and abuse, and to teach how to safely and properly use and dispose of prescription drugs. The VA/DoD Clinical Practice Guideline on Opioid Therapy for Chronic Pain was released February 2017 and new clinical support tools are available to assist you and your patients with easy-to-read, practical information on opioid treatment. Army, Air Force and Navy medical treatment facilities can order hard copies of the tools on the Army Medical Command clinical practice guidelines tool kit shopping cart website and anyone can download the materials via the links below.
- Therapy Pocket Card* — Pocket card with algorithms for assessment, start of trial and discontinuation of opioid therapy as well as recommended treatment for opioid misuse
Patient Information Guide: Long-term Opioid Therapy for Chronic Pain — Patient booklet that highlights responsible use of opioids, benefits and risks of opioid therapy, and self-management tips
- Managing Side Effects and Complications of Opioid Therapy for Chronic Pain — Fact sheet for primary care providers that explains how to properly manage side effects of opioid therapy.
- Opioid Therapy for Chronic Pain Pocket Guide (Coming Soon) — Tabbed pocket guide to help providers assess the risks and benefits of initiating or continuing opioid therapy and recommended strategies for managing tapering, withdrawal and discontinuation
- Tapering and Discontinuing Opioids (Coming Soon) — Brochure for primary care providers on strategies to safely taper, manage withdraw and discontinue long-term opioid therapy
*Developed by the Department of Veterans Affairs
Ms. Laura Faulconer is a contracted social worker subject matter expert on the evidence-based practice team at the Deployment Health Clinical Center. She has a master of social work and a master of public administration.
The views expressed in Clinician's Corner blogs are solely those of the author and do not necessarily reflect the opinion of the Deployment Health Clinical Center or Department of Defense.